Journal article
Linking Clinical Relevance and Statistical Significance in Evaluating Intra-Individual Changes in Health-Related Quality of Life
Medical care, Vol.37(5), pp.469-478
05/01/1999
DOI: 10.1097/00005650-199905000-00006
PMID: 10335749
Abstract
Objective. To compare the standard error of measurement (SEM) with established standards for clinically relevant intra-individual change in an evaluation of health-related quality of life. Design. Secondary analysis of data from a randomized controlled trial. Subjects. Six hundred and five outpatients with a history of cardiac problems attending the general medicine clinics of a major academic medical center. Measures. Baseline and follow-up interviews included a modified version of the Chronic Heart Failure Questionnaire (CHQ) and the SF-36. The SEM values corresponding to established standards for minimal clinically important differences (MCIDs) on the CHQ were determined. Individual change on the SF-36 was explored using the same SEM criterion. Results. One-SEM changes in this population corresponded well to the patient-driven MCID standards on all CHQ dimensions (weighted kappas (0.87; P < 0.001). The distributions of outpatients who improved, remained stable, or declined (defined by the one-SEM criterion) were generally consistent between CHQ dimensions and SF-36 subscales. Conclusions. The use of the SEM to evaluate individual patient change should be explored among other health-related quality of life instruments with established standards for clinically relevant differences. Only then can it be determined whether the one-SEM criterion can be consistently applied as a proxy for clinically meaningful change.
Details
- Title: Subtitle
- Linking Clinical Relevance and Statistical Significance in Evaluating Intra-Individual Changes in Health-Related Quality of Life
- Creators
- Kathleen W. Wyrwich - Saint Louis UniversityNancy A. Nienaber - Regrenstrief Inst. for Health CareWilliam M. Tierney - Indiana University HealthFredric D. Wolinsky - Saint Louis University
- Resource Type
- Journal article
- Publication Details
- Medical care, Vol.37(5), pp.469-478
- Publisher
- J. B. Lippincott Williams and Wilkins Inc
- DOI
- 10.1097/00005650-199905000-00006
- PMID
- 10335749
- ISSN
- 0025-7079
- eISSN
- 1537-1948
- Language
- English
- Date published
- 05/01/1999
- Academic Unit
- Health Management and Policy
- Record Identifier
- 9984364444802771
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